Adult ADHD Medication in the UK
In the UK there are guidelines to diagnose ADHD in adults. The number of referrals to the adult ADHD specialist clinic quadrupled in the course of the pandemic.
Non-stimulants and stimulants are both used to treat ADHD. Methylphenidate is the most commonly used medication used to treat symptoms of ADHD and is accompanied by two amphetamine-based drugs known as dexamfetamine and Lisdexamfetamine.
Stimulants
The most commonly used type of medication used to treat adult ADHD is a stimulant. These work by increasing the activity of parts of the brain responsible for the behavior and attention. They are quick-acting and often the first option that is considered by GPs. Methylphenidate, more commonly known as Ritalin, is the most widely prescribed stimulant for adults as well as children.
This drug boosts the levels of neurotransmitters in the brain, thereby improving concentration and decreasing hyperactivity and impulsivity. It can also reduce depression and anxiety that may occur with ADHD.
Throughout history, stimulant drugs have been used medicinally and recreationally, to enhance cognitive function, motivation, performance and mood. These include nicotine, caffeine amphetamines and cocaine, modafinil and methylphenidate. They also serve as appetite suppressants and energy boosters. They may cause significant psychological and physical negative effects when taken in excessive amounts.
There are a variety of different drugs used to treat adults suffering from ADHD and psychiatrists will usually carefully titrate the doses of each patient they see. They will consider any other medical issues a patient may have, and the effect of the medication on their sleeping patterns. They will also take into consideration the effects of medication on the patients' lifestyle and diet.
A large meta-analysis of networks, conducted by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug Lisdexamfetamine (commonly referred to as Adderall) is more effective than other stimulants in decreasing symptoms of ADHD. It is recommended by NICE, and it is available for prescription in the UK.
Despite the evidence-based findings, there is still some stigma attached to the use of medications to treat ADHD that is based on unhelpful framings that refer to it as child abuse, and even comparisons to controlled substances. This makes many not want to request an assessment, or even to consider taking medication for their condition.
The number of adult patients treated for ADHD increased with the increase in the number of patients referred to NHS psychiatrists during the COVID-19 epidemic. In fact adults' ADHD referrals have now surpassed those for children. Boys are still more likely to be referred for ADHD treatment, but the number women receiving it has quadrupled in just the past two years.
Unlicensed Medication
A range of medicines are licensed for treating ADHD for children and adults with stimulant drugs such as methylphenidate and sometimes the newer amphetamine-based drug lisdexamfetamine being prescribed. These are classified as 'controlled' medications because they are prone to abuse and addictive. Your consultant psychiatrist will only prescribe them if they feel they are the best choice for you as part of your treatment. You will then be given a prescription which you can visit your local pharmacy and take home. It is for a month's supply of the drug. Your pharmacist should be able to explain it to you.
In some cases your doctor may decide that the drugs they have available are not suitable for you and recommend an unlicensed drug. This is a decision that will be made on an individual basis. Your doctor should only prescribe non-licensed drugs as a last option. Keep in mind that while medication is a crucial component of treating ADHD, talking therapy also plays a crucial role. Therapy can change your coping mechanisms and behaviour patterns. Medication can manage your symptoms.
In the UK the medication used to treat ADHD among adults must have a marketing authorisation (MA) that specifies the conditions under which it is approved. This will include the age of those who can be treated and the method by which the medication should be administered. The MHRA will conduct an official evaluation of any IMP before it is released, and the manufacturer can only promote it under its MA or if it has an exclusive license for paediatric medicine.
Off label prescribing happens when a psychiatrist feels it is appropriate to prescribe a medicine for an adult even though it was approved for use by a child. A'manipulated product' is possible when pharmacists mix ingredients to create a formula for a patient that is unable to take tablets. There's an unpopularity around using non-licensed medications to treat ADHD in adults, with psychiatrists complaining about the excessive prescribing of psychoactive medications for mental health issues.
Licensing
In the UK, there are various medicines that are approved to treat ADHD in adults. There are a number stimulant medications, including methylphenidate, (Ritalin), and the newest amphetamine-based medication lisdexamfetamine (Elvanse). These are typically prescribed to patients who have been diagnosed with the condition by a psychiatrist. The treatment is typically prescribed in capsules, and patients should be monitored carefully by their doctor to ensure that the appropriate dosage is determined.
There are other ways to treat and manage the condition, aside from medication. For instance, behavioural therapies can help people understand the causes of their symptoms and devise strategies to deal with these. In addition, environmental modifications are also helpful in helping people deal with the impact of their symptoms on daily activities. This includes arranging seating arrangements at work or at school, providing cards that say 'I Need a Break' and scheduling frequent breaks for movement, as well as reducing noise and distractions.
The medications that have been approved in the UK to treat ADHD in adults aren't intended to be a cure, but they can enhance the quality of life for a lot of people. They aren't a cure-all and should only be a part of a holistic treatment plan that includes psychoeducation, psychiatric treatment, and medication.
Patients who are pregnant should undergo a pregnancy test prior starting any medication. They should also inform their GP when they become pregnant or want to become pregnant. Patients should also talk to their GP for any side effects or if they don't think they are gaining.
A national alert for patient safety concerning the shortage of methylphenidate extended-release tablets, extended-release guanfacine tablets, and lisdexamfetamine capsules was released on September 27, 2023. It was replaced by an Medicine Supply Notification (MSN) on 08 May 2024 that lifted the restrictions on prescribing for Elvanse capsules and urged ADHD services to resume the initiation of treatment.
It is a Schedule 2 controlled drug so it must be prescribed by an accredited practitioner and is subject to the Misuse of Drugs Regulations 2001. how to get adhd medication uk recommend that an ADHD patient be evaluated annually by a healthcare professional who is knowledgeable and trained in managing the disorder. This can be done in primary care or secondary care, based on the local arrangements. This review should include monitoring of blood pressure and heart rate as well as a discussion about the need for continued treatment, and continuous monitoring and evaluation of symptoms improvement.
Side Effects
ADHD medication is safe and generally well accepted by adults, but it doesn't cure the condition. It can help to reduce symptoms of behavioural disorder and improve quality of life. It can also assist with learning, work and relationships.
It is important that anyone who is beginning treatment be aware of possible side effects. They should discuss these with their doctor prior to starting the medication. Side-effects can include an increase in appetite, headaches and sleeplessness. Certain medications can increase heart rate. It is usually mild and harmless but is something to mention to your doctor if you have a previous history of heart issues or cardiovascular disease.
The effects of stimulants increase the levels of norepinephrine and dopamine in the brain. This alters the way that the brain receives and sends messages, improving attention and focus. They are considered to be the first-line treatment for adults with ADHD. Atomoxetine and Buproprion, which are non-stimulant drugs are more complex in their action on the brain. They also take longer to begin working. The latter block dopamine reuptake into nerve cells and assists in the improvement of concentration.
According to research, around half of the children diagnosed with ADHD will overcome their symptoms in adulthood. This could be due to the fact that they develop coping skills to manage their symptoms, or because they are less hyperactive. However, a large portion remain in an environment that isn't specifically designed for them. That's why Nice recommends doctors prescribe ADHD drugs only when they are needed and keep monitoring patients on a regular basis.
There are a number of other ways to help with ADHD symptoms, including lifestyle changes and psychoeducational therapies. These therapies can be used alongside medication to lessen the need to refer people who have ADHD to specialist services.
The stigma that surrounds ADHD can make it difficult to speak openly about treatment and many adults are hesitant to reveal that they are taking it to their family, friends or employers. But, there is growing evidence that talking about the disorder and promoting awareness of its symptoms can help reduce barriers to treatment.